Collaborative Rehabilitation Environments in Acute Stroke (CREATE)

  • Research type

    Research Study

  • Full title

    Using co-production to improve patient carer and staff experiences in health care organizations: a multi-centre, mixed methods evaluation in inpatient stroke units.

  • IRAS ID

    186869

  • Contact name

    Fiona Jones

  • Contact email

    F.Jones@sgul.kingston.ac.uk

  • Sponsor organisation

    St George's University of London and St George's University Hospitals NHS Foundation Trust

  • Duration of Study in the UK

    2 years, 11 months, 31 days

  • Research summary

    Stroke often leaves people with disabilities requiring specialist stroke unit care. National recommendations for the amount of therapy are not currently being met. Studies show that inpatients in stroke units spend most of the day inactive. Stroke services need to find new ways to increase supervised and unsupervised rehabilitation activity. Patients, carers and other stroke unit staff, not just therapists, could have more active roles in this. Therefore, we propose a relatively new method of bringing together staff, former patients and carers to review and jointly redesign the way in which rehabilitation-related activity is provided in stroke units in the early days and weeks after stroke.

    The research will be conducted in 4 stroke units in England. The method, Experienced-Based Co-Design (EBCD) is a structured process for co-producing services between staff, patients and carers. It draws expressly on patient experiences and shares these with staff as the basis for service review and redesign. Although not previously tested in early phase stroke care, co-production has resulted in transformation of other healthcare services and we anticipate that this method will transform how inpatient stroke rehabilitation is delivered. We will use EBCD in 2 stroke units first, and then test the new ways of working produced in 2 additional units to see whether being part of the EBCD process is important in successfully introducing these changes in other stroke units.

    The new ways of working will be evaluated using patient-reported experience and outcome measures. We will also interview staff, patients and carers about their experiences of and views on participating in the EBCD approach. We will observe the practices of staff, and the amount and type of supervised and unsupervised patient rehabilitation activity in the study sites before and after the new ways of working have been implemented.

  • REC name

    London - Brighton & Sussex Research Ethics Committee

  • REC reference

    16/LO/0212

  • Date of REC Opinion

    11 Feb 2016

  • REC opinion

    Favourable Opinion